Targeted Therapies in CLL – Therapeutic Next Steps

At the April 2015 CLL Patient Education and Empowerment meeting held in conjunction with the CLL Research Consortium meeting at UCSD in San Diego, Dr. William Wierda from MD Anderson Cancer Center wrapped up all the information provided previously about targeted therapies (BCL-2 inhibitors, kinase inhibitors, monoclonal antibodies and high-risk disease) to look towards the future.

Focusing on therapeutic next steps, he provided a comprehensive overview of overall treatment goals for CLL, specifically:

Cure CLL

For eligible patients though allogeneic stem cell transplant

For patients with mutated IGVH, some patients have achieved extended remissions lasting over 10 years

Achieve excellent disease control for most patients through treatment with BCR inhibitors and BCL-2 inhibitors

Eliminate disease and treatment complications, such as:

Infection

Auto-immunity

2nd cancers

Secondary cancers (resulting from treatment with alkylating agents)

Dr. Wierda provided a comprehensive review of the current standards of care, considering age and chromosomal abnormalities determined by FISH:

Complete remission (an intact immune system achieved through CR is a treatment for infection)

Dr. Wierda went on to conceptualize and strategize how research should go forward using clearly defined clinical objectives to treat various patient subgroups, such as:

Elderly/frail

Younger/fit

IGHV-mutated (IGVH-M)

IGHV-unmutated (IGVH-UM)

He wraps up his talk with a review of how the currently available drugs may be used in combinations, or in sequences as a strategy to achieving cure, as well as the roles of including promising new drugs (immune-modulating monoclonal antibodies, new mAbs, cell therapy, pleiotropic pathway modulators and vaccines) in those combinations.

In appreciation, Dr. Wierda closed by acknowledging that no treatment progress is possible without the courageous patient participation on clinical trials and clinical research.

Listen to Dr. Weirda’s thoughtful review of current and future strategies to achieve a cure for CLL